Break the silence
On the occasion of World AIDS Day on December 1, a look at some of the social aspects of the HIV/AIDS issue.
Dr. NAFIS SADIK is the Special Adviser to the UN Secretary General and his Special Envoy for HIV/AIDS in Asia. She is the first woman in the U.N. to lead one of its voluntarily funded programmes. Recipient of many international awards, including her selection as the Laureate in the individual category of the U.N. Population Award 2001, Dr. Sadik has also authored several publications on health issues. In India recently to attend the Gender and Poverty Summit, 2003, she spoke with
SUCHITRA BEHAL about her concerns on HIV/AIDS. Excerpts:
You mentioned that women in our societies do not have a say in any matters specially those regarding sex. How do you think we can address this?
I THINK that this has to be dealt with by each country itself. It has to start with the top leadership particularly men who should start to speak out. We have all the laws and ordinances but these are pre-empted by culture and social values. It has to go and will only happen when those in positions of power speak out. Secondly discriminatory laws or social norms have to be discarded. Then you have to have public information, education. Such profound changes take a while to happen and have to come from within the society. This is where the pressure groups and women's groups come in. A lot of women's groups shy away from some of these difficult issues.
To talk about legal rights and economic rights is easy. But sexual rights, reproductive rights, the right to make your own decision, the right to leave your husband are more difficult. I find many women's organisations shy away from them. It needs voices, it needs commitment, it needs courage. You need people at the top to really be committed and willing to put the force of their status, of their reputation sometimes.
How do you think India has fared in coping with HIV/ AIDS given the vast disparities not only in culture but economic status too?
I think they are trying to change now.
But how far has it been successful?
I think they have all the makings of a good programme now. They are going to try this project in Bellary, which they want to make AIDS-free by 2007. They are going to do everything there. Very open discussion about safe sex, about sex workers ... I think that's a good model and we'll see what happens. The national programme has expanded; there are condom supplies, which are regular and insured for all the groups that need care and treatment, not available earlier in the public sector. They are trying to train the health workers to be less discriminatory. One of the biggest sources of discrimination and stigma are the health workers themselves. I think the Minister made a very good point saying we don't want to call it "Mother and child transmission". We want to call it "Parent and Child transmission." Women get it from the husband most of the time but we stigmatise the mother. It's a little point but makes a huge difference in terms of communication.
Have we learnt anything from the African experience?
Last year, when I went to the Asian countries; they said we are different from Africa. But I begin to think not. What the African countries like Uganda, Botswana did 15 years ago is exactly what we did too initially silence, much stigma attached to sex, we didn't want to talk about it. And look what's happened to them. If we were to chart the epidemic in the Asian countries, we could follow the African model but if you put in the interventions that we now know and the care and treatment that we have now, then the path could be quite different. I think that as we get some success with the kinds of intervention that is being taken in India today as in Pakistan the scenario will change. Here I think they have targeted four groups the sex workers; adolescents; the truck drivers and the parent to child transmission. For care and support, the first priority is the mother, then young children who have been infected by their parents and finally those who come with infections to the government hospitals.
Would it help if, like some European countries, we legalised sex workers? Then their health status could be monitored.
I came here and started to tell countries that maybe they should legalise sex workers and homosexuals. But I found that that was also not going to happen. I am now trying to say that they should be decriminalised. And I'm now talking to human rights commissions; I think we have to get a public dialogue going on these issues, because legislators are going to take this on. They think it's too difficult an issue and is going to antagonise the population. We need to get the work done from below and I feel the human rights commissions are a good place to start this.
Talking about sex education in schools, how are we going to overcome the inherent attitude resistance of teachers while approaching this subject especially in state run schools?
I think that they have to become more mandatory. I think their jobs should depend on whether they teach the subject or not they have to look at the problem of sex education and see how serious it is. They don't want to answer questions on this subject. Where should young people go? They have some hotlines but that's not enough. You have to learn to deal with the situation, times change and people change and you have to learn to deal with that. We cannot condemn our children to death. What we are doing is imposing our values and not caring what happens to our young.
Send this article to Friends by